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Publication Detail
Treatment of dermatomyositis and polymyositis
  • Publication Type:
    Journal article
  • Publication Sub Type:
  • Authors:
    Choy EH, Isenberg DA
  • Publication date:
  • Pagination:
    7, 13
  • Journal:
  • Volume:
  • Issue:
  • Keywords:
    administration & dosage, adrenal, Adrenal Cortex Hormones, AGENT, AGENTS, Antineoplastic Agents, As, balance, case report, clinical, COMBINATION, Combined Modality Therapy, Consensus, CONTROLLED TRIAL, CONTROLLED TRIALS, cortex, corticosteroid, CORTICOSTEROIDS, Dermatomyositis, diagnosis, DIFFICULT, Disability, disease, Diseases, DRUG, Drug Therapy, Combination, DRUGS, EFFICACY, Female, hormone, Hormones, idiopathic, IM, IMMUNOGLOBULIN, Immunosuppressants, Immunosuppressive Agents, intervention, INTERVENTIONS, INTRAVENOUS, LA, LONG-TERM, Male, Methods, MULTICENTRE, Myositis, NUMBER, NUMBERS, Open, optimal, outcome, Outcome measures, Patient, patients, physician, PHYSICIANS, PLACEBO, PLACEBO CONTROLLED TRIAL, Plasmapheresis, Polymyositis, Prognosis, randomized, RANDOMIZED CONTROLLED TRIAL, Randomized Controlled Trials, RANDOMIZED TRIAL, RANDOMIZED TRIALS, report, Reports, Review, Sensitivity and Specificity, SHORT-TERM, small, THERAPIES, therapy, toxicity, treatment, Treatment Outcome, TRIAL, TRIALS, Unknown
  • Notes:
    UI - 21653378 DA - 20020116 IS - 1462-0324 LA - eng PT - Journal Article PT - Review PT - Review, Tutorial RN - 0 (Adrenal Cortex Hormones) RN - 0 (Antineoplastic Agents) RN - 0 (Immunosuppressive Agents) SB - AIM SB - IM
Since idiopathic inflammatory myositis is relatively uncommon, randomized placebo controlled trials are rare. Although corticosteroids have not been tested in randomized controlled trials, general clinical consensus among physicians has accepted it as effective therapy. However, corticosteroid toxicity leads to significant disability in many patients. For patients with refractory dermatomyositis, intravenous immunoglobulin is an effective short-term treatment but its long-term effect remains unknown. Immunosuppressants are commonly used in refractory inflammatory myositis; evidence for their efficacy, with very few exceptions, has been derived from case reports and open studies with small numbers of patients. Even in randomized trials, the lack of validated and generally accepted outcome measures makes it difficult to compare the effect of interventions in different studies. Although the balance of evidence suggests that immunosuppressants are equally effective in dermatomyositis and polymyositis, there are no randomized controlled trials to show if any of these drugs, individually or in combination, is best. For uncommon diseases, such as inflammatory myositis, only multicentre randomized controlled trials involving rheumatologists and neurologists will define the optimal therapy
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